Basic nosologic units of cardiovascular pathology and examples of how to formulate diagnoses, by taking into account actual classifications are presented.

Aim – evaluation of ambulatory blood pressure monitoring (ABPM) in pregnant women with metabolic syndrome (MS) in the II trimester, revealing their relationship with specifics of endothelial function, and determinationof possible predictor values of some indicators of ABPM in the development of preeclampsia and placental insufficiency.

Materials and methods. Evaluation ABPM results performed in 82 pregnant patients with MS and 20 healthy pregnant women at 16–22
weeks of gestation.\

Results. More than in 50 % of surveyed patients common nature of MC hypertension was confirmed, which was manifested in a moderate increase in their blood pressure with a abnormality of its circadian rhythm. The presence of these symptoms correlated with hypertension in patients with new-onset abnormality of endotheliumependent vasodilatation in reactive hyperemia of brachial artery.

Conclusion. Negative predictor role of the daily blood pressure index concerning development of preeclampsia and placental insufficiency in
the future was established.

Aim – clarification of the clinical progression nature of traumatic intracranial hematoma.

Materials and methods. A comparative evaluation of neurological status, vegetative tone, level of stress (SL), and consciousness in 42 men
with different outcomes on neuroreanimation stage.

Results. It is shown that in the group of survivors by raise of the level of consciousness focal neurological symptoms come to the fore, revealed on the 10th day in 78.4 % of patients. In the case of lethal outcome to 7–9th day from decompensation and reduce consciousness to atonic stem symptoms prevailed coma at almost all patients. SL and Kerdo index proved to be reliable outcome indicators of acute period of severe traumatic brain injury (TBI). Thus, the preservation of SL and sympathic to the maximum levels for > 5 days served as a poor prognostic sign.

Conclusion. In addition to the assessment of consciousness and neurological status in the most acute period of TBI a comprehensive study of laboratory indicators of stress reactions should be included in the diagnostic algorithm which will allow to determine compensatory mechanisms status, to predict their changes and the deterioration of the patient.

Aim – to estimate the contribution of traditional risk factors in the development of cardiovascular complications (CVC) in patients with chronic heart failure (CHF) of ischemic genesis, the creation of predictive models of adverse outcome.

Materials and methods. The study included 167 patients (144 men and 23 women) aged 40 to 72 years after myocardial infarction with manifestations of CHF and written informed consent signed. All patients underwent general clinical examination, a test with a 6-minute walk test, echocardiography, determination of levels of high sensitivity C-reactive protein (hsCRP), NT-proBNP (N-terminal fragment pro-brain
natriuretic peptide). Monitoring of patients lasted for 12 months with fixing the following end points: worsening of CHF, the development of
unstable angina and myocardial infarction, death, the total number of CVAE.

Results. The development of the MTR during the year in patients with ischemic CHF is associated with age older than 60 years, body weight > 90 kg, heart rate (HR) > 70 beats/min, a distance of 6-minute test < 250 m, greater dilatation and faction ejection < 37 %, uric acid level > 250 umol/L, NT-proBNP > 250 pg/ml, hsCRP > 5.8 g/l. In the model predicting the development of the MTR in patients with ischemic CHF included age, body mass index, heart rate, uric acid levels, NT-proBNP, hsCRP, which are independent significant predictors of adverse outcome.

Conclusion. The created model allows us to calculate individual risk for the MTR in patients with ischemic CHF during the year and make the correction of risk factors for improving prognosis. The sensitivity of this model is 81 % and specificity – 85 %.

Aim – to examine the relationship of arteries wall thickness with the indicators characterizing the infectious, immune, metabolic status in
apparently healthy individuals.

Materials and methods. The study included 342 patients (mean age 43.7 ± 0.5 years) that in the process of cluster analysis on the thickness
of the intima-media thickness (IMT) were divided into 3 groups. Group 1 consisted of patients with no risk factors of cardiovascular disease,
2nd – patients with presence of these factors, 3rd – patients with atherosclerotic plaques in the carotid artery. All patients were examined
in complex: ultrasound of vessels measurement on the Aloka 5000 with IMT, evaluation of lipid profile, glucose level, determination of C-reactive protein (CRP) in blood plasma and cytokines – tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), interleukin (IL) -1, -8, -4, specific antibody immunoglobulin G (IgG) to cytomegalovirus (CMV), herpes simplex virus type 1 (HSV-1 ), C. pneumoniae, H. pylori and β-hemolytic streptococci group A. Immune system status was assessed by innate and acquired immunity factors.

Results. In groups of examined patients by increasing IMT of the common carotid artery infectious viruses (CMV, HSV-1) burden increased,
what was obligatory for all groups. In the 3rd group, in 45 % of patients C. pneumoniae was found. In the 2nd and 3rd groups weakening of
acquired immunity was found out – reducing the total number of lymphocytes and T-lymphocytes, the increase of CRP and proinflammatory cytokines (IL-1, -8, IFN-γ, TNF-α), it was indicating development of inflammatory process, and in the third group it took characters of the system inflammatory response. In cluster analysis it was revealed that the process of thickening of the vascular wall is influenced by complex factors – infectious, metabolic and immune.

Conclusion. The presence of the close relationship between the thickness of vessel walls and infectious, metabolic (lipid) and immune parameters
was established. Infection factor has an effect on the vessel wall in the face of declining immune resistance of the organism and may be an inducer of latent inflammatory process.

Aim – assessment of quality of life (QoL) in patients with rheumatoid arthritis (RA) with the presence and severity of bronchopulmonary lesions.

Materials and methods. The study included 104 patients with RA and 100 patients not suffering from RA and verified chronic respiratory diseases. The analysis of the QOL of patients using questionnaires EQ-5D (EuroQoL Group, 1990) and SGRQ (St. George's Hospital questionnaire to assess respiratory function), performed spirometry, bodyplethysmography , pulse oximetry, the definition of lung diffusion
capacity, multispiral computed tomography of the lungs.

Results. Performance of all scales and the resulting indices of questionnaires EQ-5D and SGRQ showed a significant decrease in QoL of
RA patients compared with those in control group and the general population. A correlation index of EQ-5D with vital capacity (r = 0.47;
p < 0.001) and diffusion capacity (r = 0.67; p < 0.01) of the lungs is revealed. The main reason for the reduction of indices of the questionnaire SGRQ in patients with RA was the presence of shortness of breath. The multi-factorial origin of dyspnea in patients with RA with the
essential role of bronchopulmonary lesions was established.

Conclusion. Bronchopulmonary lesions in the underlying disease have an adverse impact on the QOL of patients with RA. Promising directions for improving the QOL of RA patients with bronchial lesions can be considered for activities for the conservation of respiratory lung function, exercise control RA activity, elimination of anemia correction of psycho-emotional disturbances of anxiety-depressive character.

Aim – to identify disorders of autonomic regulation of cardiac activity in patients with psoriatic arthritis (PsA) by determining the heart rate variability (HRV), and also establish the relationship of HRV with systemic inflammation and traditional cardiovascular risk factors.

Materials and methods. The study included 53 patients with PsA (mean age 43.64 ± 12.1 years), including 48.2 % men, mean disease duration
was 10.32 ± 10.2 years. The control group included 25 healthy volunteers (average age 46.7 ± 12.45 years, 49.1 % – men). Time and
frequency measures of HRV were analyzed. Active PsA was determined by an index DAS4, rate erythrocyte sedimentation rate (ESR), levels of C-reactive protein (CRP) and fibrinogen. Patients with clinical manifestations of cardiovascular disease, and patients with symptoms
of carotid atherosclerosis, detected by duplex study were excluded.

Results. Deterioration of HRV in patients with PsA compared with those in patients of the control group, the availability of statistically significant reverse relationship of temporal and spectral parameters of HRV with PsA activity (ESR, CRP, entezit score, DAS4), duration of arthritis, the classical factors of cardiovascular risk were established.

Conclusion. Patients with PsA had noted a violation of autonomic regulation of cardiac activity in the form of reduced HRV and activation of the sympathetic part of it. Identified changes were associated with activity of systemic inflammation and classical factors of cardiovascular risk.

The main causes of chronic pelvic pain syndrome (CPPS), and its pathogenetic mechanisms are described. The criteria of evaluation of
chronic pelvic stress pain are described .It is proposed to use ultidisciplinary approach for therapy CPPS with compulsory neurologists, chiropractic physicians, psychiatrists and therapists, urologists, gynecologists and proctologists involvement to improve diagnostic and quality of therapeutic measures.

Presented clinical case is a classical version of «amiodarone lung» in patient taking inadequate doses of the drug, probably, according to the scenario of acute clinical course

Degenerative spine disease is one of the causes of back pain. Clinical types of pain and severity of inflammatory changes in the vertebral bodies depend on the activity of pro-inflammatory cytokines. Rate of development and progression of degenerative changes in the spine structures is genetically determined. Therapy of pain syndrome associated with a degenerative disc disease may include use of methods to restore damaged intervertebral disc structures, and also use of different combinations of anti-inflammatory and analgesics therapy.

Evidence based medicine data on ability of antiplatelet, including dual antiplatelet, therapy to improve the life expectancy of patients with high risk of thrombotic complications, especially patients with acute myocardial infarction is presented in brief. The problem of choosing a drug and resistance was overcoming. Modern clinical guidelines on safe antiplatelet therapy are presented.

Aim – to estimate the clinical and pharmacological effects of ivabradine in complex treatment of patients with acute coronary syndrome and
diabetes mellitus type 2 (DM 2).

Materials and methods. The study included 36 patients with acute coronary insufficiency (unstable angina) and acute left ventricular failure
(Killip class I–III) during concomitant type 2 diabetes.

Results. Prescribing ivabradine in treatment of unstable angina pectoris complicated by type 2 diabetes led to decrease in clinical symptoms,
heart rate and reduce in number of myocardial ischemia episodes. Patients treated with ivabradine, showed a significant tendency to increase left ventricular ejection fraction (12.3 %). Mo adverse reactions were recorded, including hypotensive complications.

Conclusion. Ivabradine therapy was characterized by high ischemic and antianginal efficacy, good tolerability, did not lead to the development
of tolerance and was not accompanied by the appearance of withdrawal syndrome.

The article discusses many common clinical and laboratory features of calcific aortic stenosis (CAS) and osteoporosis in patients of advanced age. After evaluation of bone mineral density, risk factors of fractures and falls, in conjunction with bone turnover markers, 2 distinct types of osteoporosis in CAS patients were described. The active character of bone’s turnover and aortic valve calcification can not regard CAS as degenerative, but regenerative process. The article is illustrated by case history, and elucidates the possibilities of pharmacological intervention, including new bisphosphonate drug – xydiphone.